The overarching goal of the K24 award is to improve the quality of care for injured trauma survivors with PTSD who initially present for treatment to acute care medical settings. The specific aims of the K24 application are to develop screening and intervention procedures targeting PTSD and related conditions after injury for diverse youth and adults, to mentor an interdisciplinary group of trainees in the design and implementation of patient-oriented PTSD clinical investigations, and to cultivate new research skills and knowledge in the areas of child and adolescent interventions and health services research. Additionally the K24 aims to combine innovative training and investigation at the interface of clinical epidemiology and dissemination research methods in order to comprehensively consider contextual factors in the development and implementation of acute care PTSD clinical investigations. These activities build upon the candidate's current NIMH R01 funded randomized clinical trial that is evaluating the effectiveness of a stepped collaborative care intervention that targets reductions in PTSD symptoms. Trainees will be supervised in acute care clinical research settings to develop extensions of the R01 intervention for underserved ethnic minority and youth injury survivors. Specific research projects proposed in the K24 include investigations of ethnocultural diversity and PTSD, studies of the associations between adolescent injury and the development of PTSD and related co-morbidities, nationwide assessments of trauma center readiness for implementation of PTSD screening and intervention procedures, and investigations comparing indices of intervention reach and effective size in PTSD prevention trials. The K24 award will allow for orchestrated mentorship, career development activities, and novel research that will bring the acute care PTSD research program to the greater level of integration required to attain high impact, sustainable improvements in the quality of care for diverse acute care patients with PTSD. The short and long term goals outlined in the K24 application are in concert with NIMH research priorities described in NIMH Strategic Plan Objective 4 and PA-04-075, Mental Health Consequences of Violence and Trauma. These priorities include strengthening the public health impact of NIMH-supported research and longitudinal studies examining the effectiveness of early screening and intervention procedures for PTSD. PUBLIC HEALTH RELEVANCE: Traumatic injury and PTSD are endemic among youth and adults in the United States. Millions of Americans present for acute care injury treatment each year, yet high quality screening and intervention procedures for PTSD remain to be developed and implemented. This application proposes mentoring, career development activities, and new research that will inform the dissemination of sustainable PTSD screening and intervention procedures nationwide.